Migraine treatment.
Migraine is a primary headache disorder characterized by recurring attacks of pain and associated symptoms. Migraine sufferers require a continuum of clinical care that depends on their disability and response to treatment. Treatment consists of: (1) prevention of attacks by avoidance of triggers; (2) the use of nonpharmacologic treatments; (3) treatment of the acute attack; and (4) long-term prophylactic therapy. Migraine is comorbid for affective disorders, epilepsy, stroke, and mitral valve prolapse. The therapy selected depends on the headache severity and frequency, the pattern of associated symptoms, comorbid illnesses, and the patient's treatment response profile. Acute treatment can be symptomatic or specific, using drugs such as dihydroergotamine (DHE) or sumatriptan. Preventive treatment can be episodic, subacute, or chronic. The major drug groups include beta-adrenergic blockers, anti-depressants, calcium channel blockers, serotonin antagonists, anticonvulsants, and nonsteroidal anti-inflammatory drugs (NSAIDs). These can be divided into two major categories and second-line choices.
Young
W B
WB
Jefferson Headache Center, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107, USA.
Silberstein
S D
SD
Dayno
J M
JM
D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D001676:Biofeedback, Psychology; D003131:Combined Modality Therapy; D006801:Humans; D008881:Migraine Disorders / Q000188:drug therapy / Q000517:prevention & control / Q000628:therapy*; D009407:Nerve Block; D012702:Serotonin Antagonists / Q000009:adverse effects / Q000627:therapeutic use
D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000928:Antidepressive Agents; D012702:Serotonin Antagonists